why does MCV change regularly

I am wondering about by blood test results:
MCV is 61
MCH 21
and i neither have anemia nor iron deficiency
my questions is why does my MCV change a lot ranging from 61 to 66?

my  mcv    was  76  in  2005
then  in  2010  my  mcv  was   81
then  in  2012   my  mcv  was    79
my  doctor    says  my  mcv  will  not  go   above  81
no  matter  what  i  do 
i  have  alpha  thalasemia  minor
and  schizophrenia
blood  type  is  ab-positive

I think that MCV would vary from test to test because it is a measure of the overall red cell volume, including the defective red cells. Each sample may be a bit different and each lab may give varying results. The difference from one test to the next is not significant.

Hi All. I hail from India. Please help me understand my situation. I have always been low on hb since i was a child..and my blood work always show increased rbc and reduced mcv...have checked for beta thal..which comes negative...I have a 7 month old baby..recently my brother happened to do his blood test which showed similar characteristics like mine...so for curiousity sake i saw a heamotologist...he ordered iron studies and alpha thal ..by PCR method.. It shows i have iron defecieny...( i am breastfeeding my baby) and also i have come positive for alpha  thal  3.7 deletion ...and it shows homozygous !...doc says the report means i m thal major ! however i have never had any symptoms other than mild anemia...none of my family members have thal. Doc says since i have no symptoms..he shall treat me as thal minor ...I am utterly confused ! Am i thal major or minor ? homozygous means all alpha globin genes are deleted ...then how have i survived for 30 yrs withour transfusion ? Will my baby also have thal minor ? my husband has no problem...please help!

Hi All. I hail from India. Please help me understand my situation. I have always been low on hb since i was a child..and my blood work always show increased rbc and reduced mcv...have checked for beta thal..which comes negative...I have a 7 month old baby..recently my brother happened to do his blood test which showed similar characteristics like mine...so for curiousity sake i saw a heamotologist...he ordered iron studies and alpha thal ..by PCR method.. It shows i have iron defecieny...( i am breastfeeding my baby) and also i have come positive for alpha  thal  3.7 deletion ...and it shows homozygous !...doc says the report means i m thal major ! however i have never had any symptoms other than mild anemia...none of my family members have thal. Doc says since i have no symptoms..he shall treat me as thal minor ...I am utterly confused ! Am i thal major or minor ? homozygous means all alpha globin genes are deleted ...then how have i survived for 30 yrs withour transfusion ? Will my baby also have thal minor ? my husband has no problem...please help!

Hello and Welcome to thalpal,

First of all, you cannot be Alpha Thal (Major). Alpha Thal 3.7 deletion is a very common mutation. There are 4 alpha globin genes and if 2 of those genes are affected the rest of the genes help in making the alpha globin.

The report must refer to one set of your alpha genes. One set is deleted while the other is normal. If you have the DNA results, I can look at them to confirm this.

Thanks for your replies Narendra and Andy. I have attached the report.

Hi Andy...i have uploded my report...please clarify my doubts.

Yes, as we have advised, one of the two pairs of alpha genes is deleted. This makes you an alpha thal trait or alpha minor. You should not require blood transfusions at anytime. I do suggest daily folic acid supplements for all alpha thals. It is also wise to avoid fava beans, all sulfa drugs and chemical fumes, like moth balls and gasoline, as the fumes can cause a reaction that destroys red blood cells, temporarily causing a lower Hb level, in many alpha thals.

What about my baby? My husband has no problem. Also..i have researched on the internet and it seems in case one set of genes is deleted it could be --/αα or -α/-α , which one m i ? How do i tell?

All your children will have a 50% chance of carrying the alpha deletions. Homozygous alpha trait means that both deletions are in the same gene cluster, so it would look like --/αα. All children should eventually be checked to see if they carry this deletion, as they need to know this information so that they can make informed decisions when it comes time to have children of their own. If any children are carriers, there mates should be tested before having children of their own.

patjessy,

As Andy mentioned, if your husband is NOT having a any gene deletion, your children would NOT be Alpha Thal (Major). I would urge you to do a complete DNA test for your husband as you want to be absolutely sure that he does NOT have any gene deletion on Alpha Globin gene. Just Electrophoresis does not give a complete picture with Alpha genes.

Look at this picture for reference : http://www.thalassemiapatientsandfriends.com/index.php?action=gallery;sa=view;id=280
Look at Scenario 1 (bottom half). The 2 shaded genes are mutated in your case, the other two are fine.

Also, I would ask you to talk with your siblings on getting themselves tested as they might in the same boat as you and if they plan a child with another Thal carrier, they might have a Thalassemia (Major) child.

Do let us know if you still have any questions.

Thanks for your answers. Couple of more questions, my baby is 7 months old. When should i get her dna checked? Also, will she have any health problems being a thal minor.
Andy,
        In your previous post you mentioned I should be taking folic acid, i have however not taken folic acid tabs until i planned to have a baby. My hb has being around 12 at times 11.5 but not lower then that, I have somehow always been iron deficient..so i m on and off on iron tabs. So is folic acid essential now? Also,if my baby also has a triat we need to put her on folic acid ? Will she have any kind of health issues...She is fine right now...has met all the milestones on time. How do i know if there is any prob?

Narendra,

            I saw the picture, it gives me a better understanding of my situation. My finding of being a minor was just an accident...I think my brother is also a minor, he has the same kind of cbc reports...i have checked my mothers reports, looks like she is a carrier. We never knew we had this prob in the family. I wonder how many people around us have this prob but are unware of it.

Awaiting your replies....

Thanks for your answers. Couple of more questions, my baby is 7 months old. When should i get her dna checked? Also, will she have any health problems being a thal minor.
Andy,
        In your previous post you mentioned I should be taking folic acid, i have however not taken folic acid tabs until i planned to have a baby. My hb has being around 12 at times 11.5 but not lower then that, I have somehow always been iron deficient..so i m on and off on iron tabs. So is folic acid essential now? Also,if my baby also has a triat we need to put her on folic acid ? Will she have any kind of health issues...She is fine right now...has met all the milestones on time. How do i know if there is any prob?

Narendra,

            I saw the picture, it gives me a better understanding of my situation. My finding of being a minor was just an accident...I think my brother is also a minor, he has the same kind of cbc reports...i have checked my mothers reports, looks like she is a carrier. We never knew we had this prob in the family. I wonder how many people around us have this prob but are unware of it.

The child can be tested later on. As we said earlier, nothing to worry about for now. If you absolutely want to know the answer get your husband tested. If he is NOT an alpha thal carrier - the child will NOT be a Alpha Thal (Major)

It is good that you found out you are a carrier. There is not much to worry being a thal carrier. Amitabh Bachhan is also a carrier but lives a normal life, so do thousands of folks around the world. A lot of folks don't know they are Thalassemia carriers until later when it is difficult to manage their child's condition.